Basic Information
| Provider Information | |||||||||
| NPI: | 1831784123 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEPLEY | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | DENNISE | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15 N 3RD ST STE 300 | ||||||||
| Address2: | |||||||||
| City: | NEWARK | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430555550 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6144878758 | ||||||||
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| Practice Location | |||||||||
| Address1: | 15 N 3RD ST | ||||||||
| Address2: | |||||||||
| City: | NEWARK | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430555550 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7403497511 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2021 | ||||||||
| LastUpdateDate: | 03/08/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | N | Agencies | Community/Behavioral Health | 163W00000X | RN.468956 | OH | Y | Nursing Service Providers | Registered Nurse |
No ID Information.